Cognition Predicts Quality of Life Among Patients With End-Stage Liver Disease
Paulson D, Shah M, Miller-Matero LR, Eshelman A, Abouljoud M. Cognition Predicts Quality of Life Among Patients With End-Stage Liver Disease. Psychosomatics. 2016 Sep-Oct;57(5):514-21.
BACKGROUND: Impaired cognitive functioning and poor quality of life (QoL) are both common among patients with end-stage liver disease; however, it is unclear how these are related.
OBJECTIVE: This study examines how specific cognitive domains predict QoL among liver transplant candidates by replicating Stewart and colleagues' (2010) 3-factor model of cognitive functioning, and determining how variability in these cognitive domains predicts mental health and physical QoL.
METHODS: The sample included 246 patients with end-stage liver disease who were candidates for liver transplant at a large, Midwestern health care center. Measures, including the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, Shipley Institute of Living Scale, Short-Form Health Survey-36 Version 2, and Hospital Anxiety and Depression Scale, comprised latent variables representing global intellectual functioning, psychomotor speed, and learning and memory functioning.
RESULTS: Confirmatory factor analysis results indicate that the 3-factor solution model comprised of global intellectual functioning, psychomotor speed, and learning and memory functioning fit the data well. Addition of physical and mental health QoL latent factors resulted in a structural model also with good fit. Results related physical QoL to global intellectual functioning, and mental health QoL to global intellectual functioning and psychomotor functioning.
CONCLUSIONS: Findings elucidate a relationship between cognition and QoL and support the use of routine neuropsychological screening with end-stage liver disease patients, specifically examining the cognitive domains of global intellectual, psychomotor, and learning and memory functioning. Subsequently, screening results may inform implementation of targeted interventions to improve QoL.
Medical Subject Headings
Adolescent; Adult; Aged; Cognition Disorders; Delivery of Health Care, Integrated; Female; Hepatic Encephalopathy; Humans; Liver Failure; Liver Transplantation; Male; Mass Screening; Middle Aged; Models, Psychological; Neuropsychological Tests; Psychometrics; Quality of Life; Statistics as Topic; Young Adult